it’s 2 am and I am still up

It’s 2 am and I am still up

Pain hit me bad around 2115 or so. My foot has been feeling like it is being crushed all day and still continues to feel this way despite my breakthrough med. But around 215, I started having severe suicidal ankle pain. This caused me so much fucking aggravation. Like the last nerve had been hit. I spoke the other day how I have all the ducks in a row and now they will call come together. I am sick of being and will be taking efforts soon to not be. It won’t be this week but sometime this month.

I am supposed to go to physical therapy in twelve hours. I am going to cancel the appointment mostly because my voice still isn’t there and I don’t want to be talking for 45 mins just for my throat to be sore the rest of the day. I will see if my voice is better next week and then have the eval then.

I sent a message to my psych to see when she wanted to talk, if she wanted to talk. I never got a response so I guess we aren’t talking. No big deal. I can try to talk to her on Tuesday. I sent her a thing she wanted me to write to try and get the therapist up to date on my suicidality. She hasn’t said anything about it so I guess it is ok. I wrote about the background and then how things are now. I also wrote about how I want her to be accountable to things we discuss and have them followed up the following week. I am tired of therapists not following through or continuing what was said the previous week. I have not printed this out. I don’t even want to see the therapist because I am afraid of what will happen. I told her some stuff about how I want to proceed in therapy from now on until the suicidality is somewhat under control. I am not sure how she will take this so I am nervous. I went through this with my long term therapist and things didn’t go well. She didn’t want to carry through on things and that frustrated me more than anything.

One of the things I talked about was the SSF (suicide status form). It is part of the Collaborating, Assessment, and Managing of Suicide (CAMS) framework. It is used to assess suicidality to get a better picture of what the episode it like for the patient. It is individualized for that patient and it really helps the clinician know where the problems or situations are that are leading to this person thinking about suicide. I have made copies of the forms from the 1st edition of the book but have not done so for the 2nd edition. The 2nd edition has the changes of a few things and on the current DSM (diagnostical system of mental disorders). The last message I had with the creator was a month or so ago and he was looking into an electronic form so that it could be easier sent to the medical record. The wonderful thing about the SSF is that it has all the documentation needed in just a few pages for the patient’s record. Right now that is just paper but eventually it will be electronic. I am not sure how that will go or if there will be a 3rd version of the book to reflect this or what. But it is in the works and last I heard would be ready sometime this year.

I don’t know if she would be interested in something she has not seen or heard of. The bottom line is that CBT and DBT (both of which she does) are also evidence based treatments for suicidality. I am not sure if this is true for chronic suicidality but I don’t think that has been studied.

1203 pm: I canceled my PT appointment. I didn’t sleep until after 0500 and with my voice being terrible, I really didn’t want to talk. Now I have the whole day to myself. It is nice out. I have one business I need to take care of before I go. I got to close my IRA account as I haven’t put any money in for years and because it is below the minimum amount, I have been charged every year, dwindling what was there. I figure I better close it before there is nothing and then be in the negative. The interest is not that great either. I just updated my book because I found it and it was only 1 to 2 cents given. I am just worried about how much taxes are going to be taken out because I am not of age to collect it. I went through this once before and it was a hassle. I think it was more because the bank didn’t want to do it than anything. Least that was my impression. Maybe I will go to the square and do it at the bank there as the one near me always gives me a fucking hassle with transactions.

I need to take a shower. I also need to change my bed sheets but that in itself is more tiring than taking a shower. My foot is a 7 right now. I know after the shower it will be up for a bit. Maybe in the afternoon I will go to do the bank business. I already had my coffee for the day so I won’t go to Starbucks. Though I might as someone misplaced or got rid of my reusable cup. I can’t find it anywhere. Maybe my nephew has it in his room. I will ask him when I see him.

any thoughts?

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